Federal Employee Health Benefits (FEHB) Fast Facts
OPM’s lowest-cost countrywide plan choice will be automatically selected for you if you don’t switch plans.
The number of providers and their makeup under the Federal Employees Health Benefits program is changing more this year than in prior years.
In light of this, OPM recently released a Federal Benefits Fast Facts bulletin that started by listing the four factors that might impact your current FEHB plan enrolment:
1. Terminating the program completely
2. Narrowing the scope of its services and removing its enrolment code
3. Narrowing the service area while maintaining the enrolment code
4. Removing an alternative (such as Standard or High)
Then it offered some questions for you to think about, which are included below.
How will I know whether this will influence my enrolment?
You will get a letter from your insurance provider informing you that it is either ceasing to offer coverage in your region, ceasing to participate in the FEHB program, or removing an option.
What should I do if something affects my enrolment?
You can switch your enrolment to a different plan during Open Season or a time frame that OPM specifies.
I plan to leave the FEHB program. What occurs if I don’t switch to a different plan?
If you don’t switch plans, OPM’s lowest-cost countrywide plan choice will be automatically selected for you.
My enrolment code is no longer valid, and my plan is expanding its coverage region. What occurs if I don’t switch to a different plan?
If you don’t switch plans, OPM will automatically enroll you in the most affordable countrywide program.
My plan’s coverage region is shrinking where I live or work, but my enrolment code is staying the same. So what occurs if I don’t switch to a different plan?
You’ll only have access to emergency care services in the new plan year; to get complete coverage, you’ll need to travel to the plan’s remaining service region.
My strategy obviates my choice. What will happen if I don’t choose another plan or one of the other options?
You’ll be enrolled automatically in one of the remaining alternatives in the plan. For example, if a High Deductible Health Plan is the only choice left, OPM will automatically enroll you in the option with the lowest-priced countrywide program.
What happens to my Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA) if my High Deductible Health Plan (HDHP) discontinues coverage in my service region or withdraws from the FEHB program?
You must sign up for another HDHP if you want to keep making contributions to your HSA. If you don’t do that, you won’t be able to contribute to your HSA, but you will still be able to withdraw money for allowed medical costs. If you don’t utilize your HRA credits before the plan you choose takes effect, you’ll lose them.
How can I switch my enrolment to a different plan?
If you work for an agency and are a FERS employee, you can use online self-service tools like Employee Express, MyPay, Employee Personal Pages, EBIS, etc. Call your HR department if you need further assistance. Also, call Open Season Express at 1-800-332-9798 if you are a CSRS or FERS retiree.
When does my old plan or option stop offering coverage and my new one start?
Your current plan will continue to provide benefits. There won’t be any voids in protection. Until the start date of the new plan you choose during Open Season or for another period specified by OPM. The first day of your first full pay period in January 2023 will mark the start of the Open Season enrolment adjustments.
What are my rights if I’m expecting or suffering from a chronic or incapacitating condition?
Enrolees who are receiving treatment from a specialist for a chronic or disabling condition or who are pregnant in the second or third trimester have the right to carry on with their care for up to 90 days or until the end of post-partum care after receiving notice that a plan is leaving the FEHB program.
How can I compare the many health plans I have access to?
There are numerous tools at your disposal to compare plans: you can use the Plan Comparison Tool or the Consult Consumer’s Checkbook to review and compare the various available programs.
Contact Information:
Email: [email protected]
Phone: 8139269909
Bio:
For over 30-years Joe Carreno of The Retirement Advantage has been a Federal Employee Retirement System specialist (FERS) as well as a Florida Retirement System specialist (FRS) independent advocate. An affiliate of PSRE (Public Sector Retirement Educators), a Federal Contractor & Registered Vendor to the Federal Government, also an affiliate of TSP Withdrawal Consultants. We will help you understand your FERS & FRS Benefits, TSP & Florida D.R.O.P. withdrawal options in detail while recognizing & maximizing all concurrent alternatives available.Our primary goal is to guide you into retirement with no regrets; safe, predictable, stable, for life. We look forward to visiting with you.
Disclosure:
Not affiliated with the U.S. Federal Government, the State of Florida, or any government agency. The firm is not engaged in the practice of law or accounting. Always consult an attorney or tax professional regarding your specific legal or tax situation. Although we make great efforts to ensure the accuracy of the information contained herein we cannot guarantee all information is correct. Any comments regarding guarantees, safe and secure investments & guaranteed income streams or similar refer only to fixed insurance and annuity products. Fixed insurance and annuity product guarantees are subject to the claimsâ€paying ability of the issuing company. Annuities are long-term products of the insurance industry designed for retirement income. They contain some limitations, including possible withdrawal charges and a market value adjustment that could affect contract values. Annuities are not FDIC insured.
